CHEST AND BRAIN SURGERY

Dominion, Volume 37, Issue 202, 24 May 1944, Page 4

CHEST AND BRAIN SURGERY

Weed For Experience Dominion Special Service. AUCKLAND, May 22. The need to maintain trained and experienced staff in the departments of hospitals dealing with'brain and chest surgery was emphasized by Dr. J. Hardie Neil iu a lecture on tracheotomy to the 8.A1.A. post-graduate course members at the Auckland Hospital. "Certain special branches of surgery, sueh as brain and chest, demand the retention of a trained staff,” he declared, "iu order to get that efficiency which is the measure of the recovery rate.” He urged, also, early operation in laryngeal and tracheal obstruction without waiting, for instance, for cyanosis to develop. Tracheotomy, he pointed, out, was most frequently required for cases of blockage.of the windpipe in the infectious diseases. In the normal cases the clinical signs would be the data on which the medical attendant would be guided, but there were other infectious diseases that menaced the airway from the larynx downwards—sueh as 4laryngo-tracheo-bronchitis, and laryngeal oedema after measles, which did not offer the same amount of time in which to await bacteriological reports, therapy, and chemotherapy. In certain of these cases definite decision was required as to whether tracheotomy was urgently called for, and to wait for clinical signs might be fatal. In laryngeal and tracheal obstruction the best recovery rate was achieved by those who, in general, operated early and who recognized that delay meant a severely deteriorated patient, with the prospect of disorderly surgery, which was always a menace to the patient’s life. Dr. Hardie Neil also advocated avoidance of the "high tracheotomy,” which often resulted in years of treatment being necessary—a treatment that was disastrous to the patient psychologically. He called attention to a recent article by a world authority, Baum, of Denver, advising the use of concentrated human plasma, which he declared was most important in, for instance, laryugo-traeheo-bronchitis. “The results are described as surprisingly good,” he said, adding that the method was to be used here at the earliest opportunity. Answering a question. Dr. Hardie Neil declared that a local anaesthetic should always be used. “The man who uses chloroform should first put in a call to the coroner,’ he commented amid laughter.